Dude… one good quote deserves another.

“So for this hospital visit I essentially paid over $9700.” – Josh Brown, iamjoshbrown.com

“Everything they do is so dramatic and flamboyant. It just makes me want to set myself on fire.” – Lucille Bluth, Arrested Development

But seriously, the argument that you paid $9700 for a splinter doesn’t work for me. In reality, you made a $9600 purchase of financial stability in the event that something real expensive happened.

I’m not saying its not an extraordinary amount of money to pay for coverage, it certainly is a lot. But to try and make the argument that you pay lotsa cash in to something and get no return for two years… that would be no different no matter how the system is. Whether that money is in taxes or premiums seems to be the main difference to me.

Even if a different health care system made it half as much: “So for this hospital visit I essentially paid over $4950″, you still wouldn’t real happy with that figure, methinks.

As for the time it took you to get service, I’m with you on that. That’s a ridiculous amount of time, no matter how you swing it.

(random aside: at our age [20's], it seems to me that the main thing insurance companies are insuring against is maternity coverage. I know when I picked a new policy at my new job, the jump for someone in the younger age brackets between maternity and no maternity coverage was like $200/mo, basically double.)

Perhaps if people used the emergency room correctly for emergencies only it wouldn’t clog the system for those who are in need of emergency help. Maybe it would have been best to wait in the morning and go to one of the Saturday doctors who are open to have your “chard”, or splinter as some would say, removed? I’m not knocking the healthcare system rant- I agree. And I hope that you will still be coming over on Monday—if you are recovering nicely and feeling up for it.

Hey Josh –
I came across your page recently via Kimberly’s blog and happened upon your blog today. (P.S. I’m one of Anna’s happy customers referred by Kimberly)
I’m an ER nurse, and I deal with this controversy every day that I work.
My hope is that you can look at the American people vs insurance companies as a cause and effect phenomenon. Let’s say you’re Patient A…20 something with a mild complaint, seldom to visit a doctor or hospital. When you get home, you’ll get your bill and you’ll pay it (the $100 copay, probably).
Let’s take Patient B…a 20 something with no insurance. She has 2 relatively well children who use the Peachcare/Medicaid system. For an ER visit, they pay no copay. For a doctor’s office, they pay a $15 copay. Little Johnny has an earache and Patient B doesn’t get paid until Friday. The answer? Let’s just take him to the ER. The time it takes to see Johnny, medicate Johnny, and discharge Johnny takes anywhere from 1-3 hours in the ER due to the cardiac arrest/respiratory distress/GI bleed next door. In a doctor’s office, this can happen in 30-45 minutes.
Now on to Patient C. A 40-something with insurance who hurt his back at work 15 years ago and ran out of his pain medicine. Then, someone rear-ended him 3 days ago. Now his back is hurting. Worker’s comp should cover the case, but now that he has had a car accident, the guilty party’s insurance should cover it. So….they fight about it and the hospital ends up writing it off because no one pays. Government health coverage would not cover this case.
Patient D – a 30 year old bipolar woman, no insurance because she can’t keep a job due to her psychological tendencies. She’s tried to kill herself and comes in unresponsive. Lots of resources are used for her – medications, radiology, labs, psychological evaluation, close 1 on 1 care, security intervention…all due to her unresponsiveness. She has to wait in the ER for 36 hours awaiting inpatient placement at a behavioral health center due to her medical hold (just like Britney Spears).
Patient E – a 75 year old woman from a nursing home. Because of slighted staffing, this patient was left in her own excrement too long one too many times, has developed decubitus ulcers to her sacrum, and how has altered mental status due to the infection. Her family goes to visit on Christmas, notices this, and calls 911 to get Grandma checked out. She has Medicare who controls the healthcare system since without Medicare compensation, no hospital can operate. She is seen in the ER, tested extensively, and admitted. However, there are no beds in the hospital because it’s the holidays and immune systems are compromised. She waits 24 hours in the ER for a bed upstairs.
Patient F – a 55 year old veteran. War injury caused serious hip problems and pain. The VA (Government Health institution) has him on a list for hip replacement which is scheduled for June because of the small number of military doctors/ORs available. He can’t take the pain, so he comes to our ER. Not necessarily a “clog,” but an unnecessary addition to our list if the VA had enough staff to operate on this man’s hip in a reasonable time frame.
Patient G – a trauma patient who has a serious head injury after a skateboarding accident. This pt would be better served at a trauma hospital, but they are all on diversion due to overcrowding so the ambulance brings the patient here. It takes 4 nurses, a doctor, a neurosurgeon, anesthesiologist, vascular surgeon, labs/diagnostics, 4 units of blood, and the assistance of the house supervisor to attend to this patient. The rest of the ER waits.
These scenarios are a good cross section of daily life in the ER. (Except the trauma situation at a low level trauma center…that may happen once a week). I could draw many conclusions here, but I think you get the gist. If you want any further explanation, please feel free to email. I’m not a crazy conservative, just a passionate nurse with an open mind.
P.S. If you made $50,000/year, how much would you pay in healthcare costs annually as a part of the national healthcare plan? I’m unsure how that will work, but I know that you will have to pay a substantial amount, just like you do now.

hey josh,

i am thinking you waited so long cause you didn’t have a life threatening problem.

and also, one of the reasons health care ins. is so high is cause ins companies have to pay for people to go to the ER for splinters when they could wait to go to the clinic.

now, that said, i am for a universal health care system.

so go figure.

thats true. but it wasn’t a splinter. and more of a chard of wood.

and i couldn’t get to it. it was broken off at my nail bed. and it wasn’t even sticking out at the top.

granted i could have gone to the clinic, but it wouldn’t have opened until monday. and i read everything online for like 2 hours and they said it could get infected and i could die. because the nail is the most easily area to get infected in the whole body. and . . . because it had been throbbing for like 5 hours. and it really was painful.

ha ha no doubt it was painful. but i am sure you would have been ok for a couple days.

i don’t have insurance at all. so what i do for stuff like that (working construction i get a lot of those injuries) is i doctor it myself. for the pain i can always find someone who has some vicodin or pints of whiskey are helpful.

good point mike. i’m just too big of a wuss to dig it out myself. i almost passed out.

kristina.
thanks for sharing your experiences. i definitely agree with you. too often i look at the problems without considering the real faces and real people. i guess i was just thinking about the people that were there that didn’t have health insurance. and the average guys like me who pay out the rear end for it. i know i’d still probably pay for it if there was government health care. but maybe i wouldn’t have to if we didn’t spend so much money on war. our military spending is currently financed by over 50% of our taxes. if we cut that in half, there’s plenty of money left over for health care.

i’m fine with leaving it in the private sector as long as there are checks and balances. and i think right now, that insurance companies (which are probably in collusion with the doctors and the pharmaceutical industry) are running wild without any checks and balances. turning something simple into a profit making machine. and there is something wrong about that when the average man or woman or family gets taken advantage of.

i know that there would be some people who would take advantage of it. but no more than who are taking advantage of it now. meanwhile, average people are getting taken advantage of. and i’d like that to stop.

Josh, your post made me laugh. Not because of your pain …

“The system is broken. Will somebody fix it?”

Over here in the UK we have socialised medicine. I could visit the emergency room, or my local doctor, or have elective surgery, every day, and not pay a penny. Our National Health Service is one of the World’s biggest employers (just behind the Red Army, I think).

And we often hear that this system is broken: not least because of the waiting times people have to endure in the emergency room. And those of the political right suggest that we need to emulate the American system… LOL.

[The debate is more complex than that, but this direct parallel is just very funny.]

I think we need more available health care for everyone. I knew a dear lady who had breast cancer, and didn’t go to the doctor because she couldn’t afford it. It just should not happen here in the US. However, a friend of mine pointed out that we would have “bigger government” with such a system.
I also have friends in Canada who like the general healthcare, but seeing a specialist, having a CAT scan, MRI or anything like that can take forever. How do we prevent this situation?

BTW – hope your finger is better. Should help carrying around a lighter wallet!!

But we have the greatest health care system in the world… right? You would have to wait in line in canada or france right? WRONG. That is bullshit the only thing that rates high about the american health care system is the HIGH costs! Health care is going to bankrupt america if the was doesn’t do it first.

Sorry for the rant, just had a strong urge to contribute. Unlike some of my colleagues, I do believe that having a painful chard of wood under your fingernail is a reason to go to the ER, especially after hours. That’s a very painful injury! (And way to go for bringing something to do…I wish we could post a sign on the door) My research has shown a rising dissatisfaction in healthcare providers inside of universal healthcare (namely in Brazil), so I have a slight aversion. I wish someone would lay out a game plan in lay terms from that standpoint for me.
Hope your finger’s feeling better!

Artard. Next time drink until it stops hurting, then disinfect with that stuff that makes it bubble up and your good. The body will heal itself.

Also. . with the new camera, why no pictures of the injury?

that’s it. i’m going to take a picture to show you how gnarley it was.

btw, kristina, the ER nurse said i had legitimate reasons for going.

you pretty much have to take a picture if you are describing an ER visit.

I am an ER nurse also, at a trauma hospital. You also have to add int he constant stream of ambulances that come int he back that no one in the lobby sees. All the patients waiting for beds that arent available upstairs. Beds closed in the ER because of short staffing. there are lots of factors that add to the wait times. I have seen 8+ hour waits for patients to come back. Most ER’s also bring patients back in level of acuity, meaning how serious their “illness” (or lack of in a lot of cases) is. The higher level of seriousness go back first. It also makes a difference depending on how many beds that particular ER had. Most people have no idea the variables that factor in when it comes to ER times. I could go on my own rant of people coming to the ER for no reason, but wont. You had a valid reason. Hope you are feeling better.

Random thought: The PF Changs at the Mall of Georgia can take down your cell number, and call you 15 minutes before your table is available, with an automated message. Now obviously some people at the ER couldn’t leave and come back, but Josh could certainly have gone back home or sat in his car or fallen asleep at home if he knew they would call him 30 or 45 mintues (estimated) before it was closer to his turn.

I realize its difficult to determine when it would be 45 minutes from his turn to get seen by a DR, but they certainly know its not any time soon when he’s been there 1 or 2 hours.

Just sayin.

that’s a great point eric. because there were so many times i just wanted to go sit in my car and listen to sports radio. or to charge my phone. but i was scared to death i was going to miss my spot. or they were going to call my name and i was going to be sleeping.

thanks for the perspective john. unfortunately, i was all too aware of the ambulances coming in from the back. which made it hard for me to get mad. i really wanted to get mad the whole time. but then i kept seeing people who obviously had stuff way worse than a mere fingernail injury. so i was pretty patient. but some of the other people there weren’t as understanding. you’re a better man than me if you have to put up with half that.

for the pain i can always find someone who has some vicodin or pints of whiskey are helpful.

Good idea!

Josh… next time you get a tiny piece of wood stuck in your finger, fly to Chicago and I will share some Jameson with you.

Shoot… if we timed it right, you could fly here, have some Jameson, and fly back and it would still take less time then you spent in the ER.

And you are right – the health care system is a broken mess and your 7.5 hours is but one anecdotal piece of confirming evidence of said brokenness.

By the way… healthcare? Or health care? One word? Or two words?

[...] news . . . my emergency room visit is getting billed out at $1200. And you wonder why I get pissed about there being a skewed [...]

We love to falsely believe we have the best of everything, especially health care, but we do not. False stories of ungodly waits in foreign nations only confuse the issue. How do we fix or health care, or at least make it better
. I am a psychologist and fully agree with your decision to seek
prompt medical attention. Leaving that splinter in for a day or two, until a cheaper provider was available could have cost you much more.
A major problem are the millions of uninsured. They do not get preventive care, wait too long for ER care, making the sitution worse and more expensive, and since they usually cannot pay, we still end up paying for them in the form of higher costs.
We need some form of universal health care which will cost those of us who can afford it, and free if necessary to those who cannot afford it. How logical is it to spend Billions every week in IRaq but contend that we cannot provide for our own citizens when they are ill?